Juvenile nasopharyngeal angiofibromas are challenging tumors to resect secondary to their vascularity and patterns of spread. The majority of tumors can be successfully removed using endoscopic techniques. This course will address: (1) pre-operative assessment and selection of patients for endoscopic surgery; (2) embolization techniques; (3) staging based on tumor vascularity; (4) endonasal and transmaxillary endoscopic approaches; (5) surgical strategy; (6) intraoperative hemostasis and surgical techniques; (7) instrumentation; (8) problem areas and surgical tips; (9) postoperative surveillance; and (10) management of residual/recurrent tumor. Techniques will be highlighted with case-based discussion augmented by extensive surgical videos. Specifically, the importance of removal of the pterygoid base to prevent recurrence, removal of tumor extending into the parapharyngeal space, managing intracranial spread to the middle cranial fossa and dissection of vascular contributions from the internal carotid artery will be demonstrated. This course will improve your ability to completely resect JNAs using endoscopic techniques.